Degenerative mitral regurgitation predicts worse outcomes in patients undergoing transcatheter aortic valve replacement

Autor: Chaim Lotan, Ronen Beeri, E. Ouzan, Chandan Devireddy, Chang Liu, Stamatios Lerakis, Haim D. Danenberg, Hina Ahmed, Kreton Mavromatis, Bradley G. Leshnower, Erhan Gonen, Vinod H. Thourani, Vasilis Babaliaros, Dan Gilon, Yi-An Ko, Israel Gotsman, Bryan Kindya, Eren Karayel
Rok vydání: 2017
Předmět:
Aortic valve
Male
medicine.medical_specialty
Georgia
Time Factors
Transcatheter aortic
medicine.medical_treatment
macromolecular substances
030204 cardiovascular system & hematology
Patient Readmission
Risk Assessment
Severity of Illness Index
Transcatheter Aortic Valve Replacement
03 medical and health sciences
0302 clinical medicine
Valve replacement
Risk Factors
Internal medicine
medicine
Humans
Radiology
Nuclear Medicine and imaging
In patient
030212 general & internal medicine
Israel
Aged
Retrospective Studies
Aged
80 and over
Heart Failure
Mitral regurgitation
Mitral valve repair
business.industry
Hemodynamics
Mitral Valve Insufficiency
General Medicine
Aortic Valve Stenosis
Recovery of Function
medicine.disease
medicine.anatomical_structure
Treatment Outcome
Heart failure
Aortic Valve
Etiology
Cardiology
Mitral Valve
Female
Cardiology and Cardiovascular Medicine
business
Zdroj: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac AngiographyInterventions. 92(3)
ISSN: 1522-726X
Popis: OBJECTIVES To evaluate the role mitral regurgitation (MR) etiology and severity play in outcomes for patients undergoing transcatheter aortic valve replacement (TAVR). BACKGROUND Multiple prior studies have investigated the influence of MR severity on outcomes for patients undergoing TAVR. Less has been published regarding the effects of MR etiology on outcomes, including its impact on heart failure hospitalization. METHODS Two hundred and seventy patients undergoing TAVR at 2 hospitals were enrolled. Each patient had a baseline and follow-up (within 30 days of TAVR) echocardiogram that was analyzed. MR was graded as none, mild, moderate, or severe, as well as functional or degenerative. We compared patient outcomes, including death and heart failure hospitalization, among none-mild MR, moderate-severe functional MR, and moderate-severe degenerative MR groups. RESULTS Two hundred and seventy patients underwent TAVR, reducing mean aortic valve gradients from 45 ± 15 mm Hg to 9 ± 4 mm Hg. On multivariable analysis, only patients with moderate-severe degenerative MR had decreased survival free of death or CHF hospitalization compared to those with none-mild MR (P = .011). Subanalysis showed patients with moderate-severe degenerative MR were more likely to be hospitalized for heart failure at 2 years compared to those with moderate-severe functional MR (P = .02). Patients with moderate-severe degenerative MR were also less likely to have improvement in MR severity at follow up (P = .01). CONCLUSIONS Special consideration should be given to patients with moderate-severe degenerative MR undergoing TAVR. As transcatheter approaches for mitral valve repair and replacement continue to evolve, moderate-severe degenerative MR patients may benefit from consideration of double valve intervention.
Databáze: OpenAIRE
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